Related Experiment Video
Updated: Mar 19, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
Published on: December 5, 2025
Observational Study on the Effectiveness of Ventilator-Assisted Preoxygenation (VAPOX) Over Bag Valve Mask (BVM)
R J Ramu1, K V Anand2, Jithin Jacob Varghese3
1Department of Emergency Medicine, Sree Gokulam Medical College and Research Foundation, Trivandrum, Kerala, India.
Purpose:
To evaluate the effectiveness of Ventilator-Assisted Preoxygenation (VAPOX) compared with Bag Valve Mask (BVM) ventilation during Rapid Sequence Intubation (RSI) in patients presenting with acute respiratory distress.
Materials And Methods:
This observational study enrolled 60 critically ill patients requiring emergency intubation. Participants aged 40-90 years were consecutively allocated to receive preoxygenation by either VAPOX (n = 30) or BVM (n = 30). Heart rate, blood pressure, oxygen saturation (SpO2), and PaO2/FiO2 ratios were recorded at baseline, postpreoxygenation, and at 1, 5, and 30 minutes postintubation. Statistical analysis used SPSS software; significance was defined as P < 0.05.
Results:
Patients in the VAPOX group reached 95% SpO2 significantly faster than the BVM group (39 seconds vs. 80 seconds, P = 0.005), despite having a lower initial mean SpO2 (85.4% vs. 88.47%). Postpreoxygenation saturation was significantly higher with VAPOX (99.37%) than with BVM (96.90%) (P = 0.001). PaO2/FiO2 ratios at 5 minutes postintubation showed significant improvement in VAPOX compared with BVM (298.53 vs. 237.67; P = 0.007). Hemodynamic parameters showed no significant differences between groups.
Conclusion:
VAPOX is superior to BVM for preoxygenation during RSI in critically ill patients, demonstrating faster oxygenation, better maintenance of oxygen saturation, and significantly improved PaO2/FiO2 ratios, thereby minimizing transient and critical hypoxemia.
Related Concept Videos
Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
Cardiopulmonary Resuscitation II: ACLS Airway Management
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Mechanical Ventilation I: Indication and Settings
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...

